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Living with Marshall-Smith syndrome

A genetic condition with early bone maturation, slow weight gain, distinct facial features, and intellectual disability.

Understanding Marshall-Smith syndrome

Marshall-Smith syndrome is a genetic disorder with advanced bone age, difficulty gaining weight, unique facial features, and intellectual disability.

Other signs can include eye differences, breathing problems, nervous system issues, heart defects, extra body hair, and flat feet. It starts in newborns and infants. Most people are the first in their family with it, due to a new (de novo) gene change.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Bones that look older than the person's age
  • Poor weight gain (failure to thrive)
  • Intellectual disability
  • Prominent forehead and bulging eyes
  • Loose joints and scoliosis
  • Fractures more easily and low bone density

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include bone and joint specialists, brain and nervous system specialists, genetic specialists and hormone specialists.

  3. Consider genetic testing

    Changes in NFIX are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Bone and joint specialists (orthopedists or orthopedic surgeons); Brain and nervous system specialists (neurologists); Genetic specialists (geneticists); Hormone specialists (endocrinologists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Marshall-Smith Syndrome Organization of the USA
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Has NFIX testing been done, and what do the results mean?
How should breathing and feeding be supported?
How often should bones and hearing be checked?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Dominant
GenesNFIX

Changes in the NFIX gene cause this condition. Most people have a new (de novo) change not inherited from a parent. It follows an autosomal dominant pattern.

GeneticNeurologicalEndocrine

Also known as: accelerated skeletal maturation-facial dysmorphism-failure to thrive syndrome; accelerated skeletal maturation, facial dysmorphism, failure to thrive syndrome; mrshss

Patient organizations

Source: NIH GARD · Marshall-Smith syndromeGARD ID 6985 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Marshall-Smith syndrome.

Explore the Marshall-Smith syndrome blog

Explore research for Marshall-Smith syndrome

Explore actively recruiting Marshall-Smith syndrome studies with HealthSpark.

HealthSpark

Find actively recruiting studies for Marshall-Smith syndrome with HealthSpark. Share your city to explore research near you.

  • Recruiting studies from ClinicalTrials.gov
  • Share your city to look for research near you
  • Eligibility is confirmed by the study team

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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